SECONDARY PREVENTION OF HEART FAILURE IN NON‐DIABETIC STEMI PATIENTS WITH NORMOCALORIC DIET SUPPLEMENTED WITH BARLEY FLOUR ENRICHED MACARONI PASTA

PURPOSE: The development of health‐functional meals to prevent heart failure in non‐diabetic patients with ST‐elevation myocardial infarction (nd‐STEMI) remains a desirable goal. We tested whether the daily intake of normocaloric diet supplemented with macaroni pasta made with durum and barley wheat flour blend (75:25) leading intake of 3g barley β‐glucan (functional pasta, FP) promotes additional cardioprotection in infarcted patients. METHODS: We randomized 37 consecutive nd‐STEMI patients (mean age 57 y.o., 8 women) undergoing primary percutaneous coronary intervention (PCI). At the fifth day after PCI, FP group (n = 19) was daily fed for 3 months with normocaloric diet supplemented with 100g/day of functional pasta “Al Dente”, whereas normocaloric diet of control group (n = 18) was supplemented with normal pasta (durum wheat 100%, NP, 100 g) similarly cooked. Echocardiography and blood analysis were performed at T0 (early after PCI), T1 (1 month after PCI) and T2 (3 months after PCI). Infarct size was measured at T0 and T2 by cardiac MRI with late gadolinium enhancement. Pharmacological treatment was the same in both groups. RESULTS: At one month of diet, LV ejection fraction was significantly increased by 9% in FP group, but not in control group. In FP group, the global longitudinal strain, a more sensitive index of myocardial contractility, was significantly improved at T1 and T2 compared to T0 by 12.17 and 16.86 % respectively. No significant changes were observed in NP group. Infarct size was similar in both groups. Fibrinogen, nitrite/nitrate and oxidative‐INDEX levels were significantly (P < 0.05) reduced only in FP patients. Despite LDL‐c levels were reduced in both groups, HDL‐c levels were increased only in FP group. CONCLUSION: Normocaloric diet supplemented with FP “Al Dente” further improves LV function of reperfused nd‐STEMI patients regardless infarct size by reducing levels of circulating oxidative and inflammatory mediators and improving lipid homeostasis.